J Korean Neurotraumatol Soc.  2008 Dec;4(2):93-96. 10.13004/jknts.2008.4.2.93.

Traumatic Interhemispheric Subdural Hematoma Presenting the Falx Syndrome after Decompressive Craniectomy: A Case Report

  • 1Department of Neurosurgery, Wonju College of Medicine, Yonsei University, Wonju, Korea. junghh@yonsei.ac.kr


Interhemispheric subdural hematoma (ISH) had been considered very rare until identification with image studies, such as brain computed tomography (BCT) and magnetic resonance imaging (MRI). There are still some controversies in the management ISH, will be treated surgically or medically. We present one case of traumatic ISH which showed the falx syndrome after decompressive craniectomy for convexity subdural hematoma and was treated surgically with good outcome. Surgical treatment should be considered for symptomatic ISH patient, because ISH did not migrate over the convexity, as showed in our case.


Interhemispheric subdural hematoma; Chronic; Falx syndrome

MeSH Terms

Decompressive Craniectomy
Hematoma, Subdural
Magnetic Resonance Imaging


  • FIGURE 1 A 56-year-old male patient was admitted to our hospital due to metal deterioration. Brain CT revealed the acute subdural hematoma on left frontotemporoparietal, so he was operated the decompressive craniectomy. A: Initial brain computed tomography showed acute subdural hematoma in interhemisphere and left frontotemporoparietal area. B: Interhemispheric subdural on hematoma was still remained postoperative computed tomography after decompression subdural hematoma on left convexity.

  • FIGURE 2 After decompressive craniectomy, falx syndrome was revealed due to interhemispheric subdural hematoma. A: At the time of falx syndrome, 22nd postoperative day, computed tomography was followed up and it showed increased size of interhemispheric subdural hematoma which was transformed to chronic form. B: After 3 days of drainage, the size of interhemispheric subdural hematoma was decreased. C: Interhemispheric subdural hematoma was absorbed totally on postoperative 3 weeks image study.


1. Aring C, Evans J. Aberrant location of subdural hematoma. Arch Neurol Psychiat (Chicago). 1940; 44:1296–1306.
2. Bartels RH, Verhagen WI, Prick MJ, Dalman JE. Interhemispheric subdural hematoma in adults: case reports and a review of the literature. Neurosurgery. 1995; 36:1210–1214.
3. Fein JM, Rovit RL. Interhemispheric subdural hematoma secondary to hemorrhage from a calloso-marginal artery aneurysm. Neuroradiology. 1970; 1:183–186.
4. Fruin AH, Juhl G, Taylon C. Interhemispheric subdural hematoma, case report. J Neurosurg. 1984; 60:1300–1302.
5. Glista GG, Reichman O, Brumlik J, Fine M. Interhemispheric subdural hematoma. Surg Neurol. 1978; 10:119–122.
6. Ho SU, Spehlmann R, Ho H. CT scan in interhemispheric subdural hematoma. Neurology. 1977; 27:1097–1098.
7. Houtteville JP, Toumi K, Theron J, Derlon J, Benazza A, Hubert P. Interhemispheric subdural heamatomas: seven case and review of the literature. Br J Neurosurg. 1988; 2:357–367.
8. Lee KJ, Koh EJ, Choi HY. Interhemispheric chronic subdural hematoma showing falx syndrome: case report. J Korean Neurosurg Soc. 2002; 32:268–271.
9. Ogsbury JS, Schneck SA, Lehman RA. Aspects of interhemispheric subdural haematoma, including the falx syndrome. J Neurol Neurosurg Psychiatry. 1978; 41:72–75.
10. Sadrolhefazi A, Bloomfield S, Stephen M. Interhemispheric and bilateral chronic subdural hematoma. Neurosurg Clin N Am. 2000; 11:455–463.
11. Takeda N, Kurihara F, Matsuoka H, Kose S, Tamaki N, Matsumoto S. Three cases of acute interhemispheric subdural hematoma. No Shinkei Geka. 1988; 16:87–92.
12. Urculo E, Martinez L, Gereka L, Olasgasti V, Olascoaga V, Urcola J. The spontaneous reabsortion of posttraumatic interhemispheric subdural hematoma. Acta Neurochir (Wien). 1996; 138:776–777.
13. Wilberger JE Jr, Harris M, Diamond D. Acute subdural hematoma: morbidity, mortality, and operative timing. J Neurosurg. 1991; 74:212–218.
14. Zimmerman RA, Bilaniuk L, Bruce D, Schut L, Uzzell B, Goldberg H. Computed tomography of craniocerebral injury in abused child. Radiology. 1979; 130:687–690.
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